talc powder, sterile (Sclerosol Intrapleural Aerosol, Sterile Talc Powder)
Classes: Sclerosing Agents
Dosing and uses of Sclerosol (talc powder, sterile)
Adult dosage forms and strengths
aerosol powder
- 4g
suspension reconstituted
- 5g
Malignant Pleural Effusion
Indicated as a sclerosing agent to decrease malignant pleural effusion recurrence in symptomatic patients
Administered intrapleurally via chest tube after adequate drainage of the effusion
Aerosol : 4-8 g (1-2 canisters); deliver by manually pressing actuator button; distal end of the delivery tube should be pointed in several different directions, while short bursts are administered to distribute talc powder equally and extensively on all visceral and parietal pleural surfaces
Powder: 5 g as single dose dispersed in sodium chloride injection 50 to 100 mL; doses range from 2 to 10.5 g shown to be effective
Pediatric dosage forms and strengths
Safety and efficacy not established
Sclerosol (talc powder, sterile) adverse (side) effects
Frequency not defined
Difficult to distinguish adverse effects of talc from adverse effects of procedures associated with talc administration
Empyema
Hypoxemia
Dyspnea
Unilateral pulmonary edema
Pneumonia
ARDs
Bronchopleural fistula
Hemoptysis
Pulmonary emboli
Tachycardia
Myocardial infarction
Hypotension
Hypovolemia
Asystolic arrest
Adverse reactions due to the delivery procedure and chest tube may include pain, infection at the site of thoracostomy or thoracoscopy, localized bleeding, and subcutaneous emphysema
Warnings
Contraindications
Hypersensitivity
Cautions
May preclude subsequent diagnostic procedures of the pleura on the treated side, in including ipsilateral lung resective surgery and pneumonectomy for transplantation purposes
No known antineoplastic activity and should not be used alone for potentially curable malignancies where systemic therapy would before appropriate; does not exhibit antineplastic therapy
May cause pulmonary complication (eg, acute pneumonitis, ARDS)
Keep Sclerosol (aerosol) away from any heat source that could cause it to explode
Pregnancy and lactation
Pregnancy category: B
Lactation: Not studied
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Sclerosol (talc powder, sterile)
Mechanism of action
Induces inflammatory reaction; this reaction promotes adherence of the visceral to the parietal pleura, thereby obliterating the pleural space and preventing reaccumulation of pleural fluid
